Recurrent Benign Paroxysmal Positional Vertigo: Analysis Of 170 Patients

Background: Benign paroxysmal positional vertigo (BPPV) accounts for 20% of the diagnosis in specialized centers. The recurrence after an effective treatment has been reported in 20–50%. Objective: To assess the rate of recurrence of BPPV and search of related comorbidities. Patients and methods: Retrospective chart review of 170 patients with recurrent BPPV, analysis of epidemiological characteristics and the number of canalith repositioning procedures (CRP). The definition of recurrence was any new attack that occurred at least one month after the resolution of the first BPPV. The chi-square test was used to assess the relationship between comorbidities and recurrence BPPV. Statistical significance was defined as p < 0,05. Results: 674 patients had diagnosis of BPPV between 2007 and 2011 in our neurotology unit, 170 (25%) were defined as recurrent BPPV. The mean age was 62 years and 125 (73.5%) were female. Posterior semicircular canal was involved in 89% of recurrences. The media of recurrence was 2.04 BPPV episodes per patient. The number of CRP increased along with patient's age. Regarding the evaluated comorbidities: 43% had arterial hypertension, 37.5% high levels of blood lipids, 30% migraine, 24.2% stroke, 21.2% hypothyroidism, 22% tensional headache, 18.8% head trauma, 14.7% diabetes and 11% smoked. A value of chi squared of 8.12 was calculated for lacunar stroke in patients with recurrent BPPV (p = 0.004) and for patients with stroke, was 6.88, p = 0.009. Conclusion: A relationship between microangiopathic damage and BPPV recurrence has been observed, but more studies are needed in order to demonstrate the validity of this hypothesis.